CMS Formulary

Displaying 230371-230380 of 1611142 results.
ID: 230371
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230372
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230373
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230374
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230375
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230376
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230377
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230378
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230379
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 230380
Formulary ID: 00021099
Formulary Version: 10
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0